Objective:To evaluate the effect of of twin block appliance in the early treatment of class Ⅱ malocclusion.Methods:20 cases with class Ⅱ malocclusion were treated with Twin block appliance.Cephalometric analysis was used to evaluate the effects.Results:The twin block appliance could stimulate the growth of mandible and lead to retrocline of the upper incisors and procline of the lower incisors.Conclusion:The twin block appliance can achieve remarkable effects of growth modification of dentognathic system.

Astract: Objective To explore the efifcacy and safety of endoscopic tissue adhesive injection in treatment of gastric variceal bleeding from liver cirrhosis.Methods Object of study are 92 cirrhotic patients (72 male/20 female) in hospital, who had been diagnosed with gastric varices bleeding from June 2014 to May 2016. Child-Pugh score at presentation for cirrhotic patients was A-28; B-36; C-28. According to endoscopic classiifcation of gastric varices, GEV1 were detected in 80 patients, GEV2 in 12. All patients were treated with endoscopic hypertonic glucose tissue adhesive ‘sandwich’ injection.Result Successful injection rate was 100.0% in 92 patients, among which 40 patients had accepted emergency endoscopic treatment and the immediate hemostasis rate was 100.0%. 65 patients were Having gastroscope review after the injection six months, 22 patients were significantly effective, accounting for 33.8%; 38 patients were effective, accounting for 58.4%; 5 patients were invalid, accounting for 7.7%. All the patients were followed up in 1 to 24 months. The late-rebleeding rate was 2.2%. None of them were having early-rebleeding or dead; Complications the incidence of rebleeding rate which caused by removing the needles which trapped in the varices was 2.2%. The incidence of chest pain rate was 4.3%, the bloating rate was 6.5% and the ulceration rate was 15.2%. There was no complications like fever, infection, stomachache, embolism and so on.Conclusion With low rebleeding rate and light side-effect, endoscopic tissue adhesive injection in the treatment of gastric variceal bleeding caused by cirrhosis portal hypertension has really good effect.

Objective: To investigate the three-dimensional morphological characteristics of the upper airway in children and adolescents with skeletal class Ⅲ malformation and to explore the relationship between craniofacial structure and upper airway morphology. Methods : Ninety cases of malocclusion aged 3-18 years were collected. In addition, 45 cases of type I and type Ⅲ were classified into three age groups with 15 cases in each group: 3-6 years old, 7-12 years old and 13-18 years old. CBCT was taken, and the scanning data of CBCT were reconstructed by the third-party software Invivo 5. The volume, minimum cross-sectional area, height and the ratio of sagittal diameter to transverse diameter at the minimum cross-sectional area of each segment of the upper airway were measured. The difference of the upper airway between skeletal class I and skeletal class Ⅲ in each age group was analyzed and compared by group t test. Results : No significant differences in the upper airway indexes were noted between skeletal class I and skeletal class Ⅲ(P > 0.05) in the 3-6 years old group. In the 7-12 years old group, the total volume of skeletal class Ⅲ upper airway (16.25 ± 3.69 cm 3), nasopharyngeal segment (2.39 ± 0.90 cm 3), and palatopharyngeal segment (5.24 ± 1.14 cm 3) were reduced compared with the total volume of the skeletal class I upper airway (20.98 ± 6.25 cm 3) , nasopharyngeal segment (4.21 ± 1.09 cm 3), and palatopharyngeal segment (8.18 ± 2.02 cm 3), respectively, the differences were statistically significant (tVtotal=2.526, tVnose=4.999, tVpalate=4.908, P < 0.05). In the 13-18 years old group, only nasopharyngeal segment volume (3.83 ± 0.90 cm 3) was reduced in skeletal type I (4.69 ± 1.34 cm 3); the difference was statistically significant (t=2.053, P < 0.05). Conclusion Age is an important factor affecting the morphology and structure of upper airway in skeletal Ⅲ malocclusion.

This case report describes the treatment of an adult female patient with a history of periodontal disease, Class I malocclusion with extrusion, dental spaces, and pathologic tooth migration. The patient was treated with clear aligners, which effectively controlled the strength and direction of orthodontic forces after 3 months of systematic periodontal treatment. The Peer Assessment Rating (PAR) index was calculated from study models before and after treatment. The pretreatment PAR score was 24, and the posttreatment PAR score was 4. The PAR score for this patient changed by 83%. Satisfactory appearance and good function were achieved for this patient.

Objective To explore the distributions and clinical characteristics of pathogenic bacteria in SAP patients with secondary infection.Methods We collected clinical data from SAP patients with secondary infection,to analyze the source of samples,pathogenic bacteria and its resistance to commonly used antimicrobial agents.Results (1) Samples Source:A total of 156 positive specimens were obtained,with the largest number from sputum samples (46.79％);The blood samples (70.59％) were collected most within 1 week,sputum samples (64.38％) from 1 week to 2 weeks,and pancreatic necrotic tissues or peripancreatic fluid samples (51.79％) after 3 weeks,with statistically significant differnces.(2) Pathogenic bacteria:156 strains were isolated including 86 strains (55.13％) of gram-negative bacteria (55.13％),of which acinetobacter baumannii and escherichia coli were the most commonly seen,followed by gram-positive bacteria of 41 strains (26.28％),and then fungus of 27 strains (18.59％).(3) Drug resistance:There was a high tolerance rate of commonly used antimicrobial agents,and the drug resistance rate of cinetobacter baumannii to carbapenems antibiotics was 88.00％.Conclusions SAP combined with secondary infection is mainly caused by gram-negative bacteria,and there is a high proportion of multidrug-resistant bacteria.Selecting suitable antimicrobial agents according to bacterial culture is beneficial for the early control of infections.

Mesenchymal stem cells (MSCs) play an important role in skin wound repair because of their multi-directional differentiation potential, hematopoietic support and promotion of stem cell implantation, immune regulation and self-replication. Exosomes contain proteins and RNAs, which have anti-tumor immunity, angiogenesis promotion and other physiological functions. Different MSCs-derived exosomes have different mechanisms in the skin traumatic action. The author summarizes the research progress of different MSCs-derived exosomes in the field of skin tissue repair through elaborations on the traditional treatment methods for skin damage, the biological properties of exosomes, the mechanism of MSCs-derived exosomes in skin wound repair and in other diseases, providing reference for improving clinical repair.

Exosomes are phospholipid bilayer vesicles secreted by living cells that can carry a variety of signaling molecules, such as RNA, DNA, protein, and lipids. Exosomes play a role in the transmission of signaling molecules between cells, thus regulating many physiological and pathological processes. The methods of extracting exosomes include differential centrifugation, density gradient centrifugation, exclusion chromatography, ultrafiltration, coprecipitation, polymer immune affinity, microfluidic separation technology, etc. Each of these extraction technologies has advantages and disadvantages; however, there is no unified international standard. In addition, the expression of specific proteins and genetic material of exosomes from different cell sources are different; thus, their expression characteristics and functions are also distinctive. Based on this situation, research on exosomes is limited to preclinical studies, and difficulties and challenges still exist in clinical application. This paper summarizes the progress of research in the field of exosomes, to understand the characteristics, modification and application of exosomes from different cell sources, and to summarize their advantages and disadvantages as well as challenges, which can help researchers better understand and master the performance of exosomes. Furthermore, improvement of standard procedures in the extraction and manufacturing of exosomes is important, as it will provide a reference for researchers to carry out exosome-related translational clinical research.

Cell therapy based on mesenchymal stem cells (MSCs) has been a hot research topic in recent years, including the traditional cell therapy strategy based on living cells and the new cell-free therapy strategy based on soluble proteins or bioactive molecules such as extracellular vesicles (EVs). At present, MSC-induced cells have mature functions and specific structures, and insitu transplantation combined with biomaterials or organic technology has greatly improved the settlement rate and function. On the other hand, as the large-scale culture technique and EVs separation technique evolve, it is possible to obtain a large number of pure EVs, and EVs are gradually becoming a hot spot of current research. An increasing number of studies have shown that the therapeutic effect of MSCs not only occurs by implantation and differentiation but also manifests as the paracrine effect of MSCs. In this review, we discuss the emerging outcomes of cell therapies and acellular therapies to alleviate these pathological conditions.